While no one can put a price tag on a healthy, mobile, pain-free spine, if you are considering spinal surgery, you should be aware of the costs involved. Most health insurance plans now pay for a large part of disc replacement surgery costs, but not all of them do. Even if insurers pay a portion, patients still bear expenses in deductibles, supportive care, and time off work. In this article, we provide the details about artificial disc replacement surgery costs you need to know.
The core cost of disc replacement surgery includes the surgeons’ fee, the anesthesiologist’s fee, device fee and the facility fee. These fees are usually bundled into one or two bills (but ask your surgeon’s office what to expect). If health insurance does not pay for your disc replacement surgery at all, the surgeon and assist surgeon, anesthesia and facility costs could range from $30,000 to $50,000 for a one to two level replacement. Why such a large range? Disc replacement surgery tends to be more expensive in the United States and in larger US cities than in other countries or less populated areas. One reason for this difference is that surgeons in larger US cities tend to treat more patients with disc replacement and have developed an expertise that surgeon’s in less populated regions do not possess.
It is important to realize that there are costs associated with pre-operative and post-operative care. Prior to surgery, most patients require at least one pre-op evaluation with bloodwork, X-ray, and ECG studies. Separately, your surgeon will likely need at least one MRI and perhaps CT and/or X-rays of the problem spinal area. You may need physical therapy or rehabilitation after the procedure. While health insurance usually covers these costs, most people have a deductible they must pay—a portion of the billed cost. These deductibles are all different as every insurance plan is different. Thus, most people should plan on checking with their health plan or the surgeon providers surgery scheduler regarding out of pocket or pre- and post-operative costs.
Most spinal surgeon’s have moved to “same day” surgery for artificial disc replacement. This means the patients stay for 23 hours or less in a healthcare facility before discharge. Same day surgery is only appropriate for people who are generally healthy and are unlikely to experience complications from spinal surgery. Keep in mind that surgical complications could translate to a brief hospital stay and additional expenses. Each day in a hospital surgical floor can cost over $4,000 per day.
People who perform physical labor as part of their work may not be able to return to their jobs after disc replacement surgery for up to 6 weeks. People with office jobs that require little to no physical exertion, on the other hand, may return to at least part time work within 1 to 2 weeks after disc replacement surgery. You may need to discuss paid time off and medical leave with your employer to determine how this recovery period will affect your income and employment.
Lumbar disc replacement is more technically challenging than cervical disc replacement surgery. Likewise, two-level disc replacements are far more technically challenging that one-level replacements. Consequently, lumbar disc replacement procedures tend to be about 50% more expensive than cervical disc replacement procedures at a given surgery site. Moreover, the cost of two-level artificial disc replacement can be nearly twice as much as a single level procedure.
Is there anything else they should know? Information on payment plans or items you commonly share with patients.
A: Most people who have had artificial disc replacement would say yes, the price of ADR is worth it. When you consider that people who need spine surgery are often in terrible pain and have significant disability, the value of surgery to correct these issues is incalculable.
A: Perhaps surprisingly, spinal fusion is about 20 to 30% more expensive than one level artificial disc replacement.
A: In most cases, artificial disc replacement is a better value. First, the cost of artificial disc replacement is less than spinal fusion. Second, the recovery time after artificial disc replacement is faster than spinal fusion. Third (though perhaps most importantly), patients have great spinal mobility after artificial disc replacement than spinal fusion. Fourth, studies show that overall costs are much less with ADR over fusion in long term.
A: Most insurance companies do cover the cost of artificial disc replacement surgery, but not all. Thus, it is important to determine if your health insurance company and your specific policy covers the cost of artificial disc replacement surgery. Also find out what your deductibles will be.
A: Yes, same day surgery is considerably less expensive than surgery that requires a hospital stay. However, same day surgery is not always an option. If you are at risk for complications (older age, diabetes, smoker, high blood pressure, obesity, etc.), it is usually a safer option to choose hospitalization for initial recovery, regardless of expense.
A: Many spinal surgeons offer payment plans to help patients spread the cost of artificial disc replacement surgery out over time. This is especially important in cases where insurance does not cover the cost of the procedure. When discussing cost with your surgeon’s office, ask about payment plans or low interest loans.